Prediction of in-stent restenosis based on systematic and retrospective analyses

Coronary restenosis is a pressing challenge in cardiovascular diseases with an annual incidence of 3 – 4%. The aim of the study was to assess the influence of known risk factors in predicting coronary restenosis in a systematic analysis and an original retrospective survey. In the first stage, we performed a systematic review of restenosis risk factors using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. In the second stage, we searched for the restenosis risk factors in 15,000 patients who had undergone coronary angiography, considering risk factors identified during the first stage. From the second stage, we identified 516 patients with restenosis versus 282 patients without restenosis. Coronary risk factors included male sex (hazard ratio [HR] = 2.194; confidence interval [CI]: 1.5 – 3.22) and history of myocardial infarction (HR = 1.098; CI: 1.05 – 1.15). Moderate-diameter stenosis (2.75 – 3.5 mm) exhibited a protective effect on restenosis (HR = 0.713; CI: 0.58 – 0.87), whereas small-diameter stenosis did not. Drug-eluting stents reduced the risk of restenosis (HR = 0.554; CI: 0.41 – 0.75). The risk factors for coronary restenosis included male sex, history of myocardial infarction, small-diameter stent, and the use of bare-metal stents.